Medication Package

ABSTRACT

A medication package enabling a single prescription to be written by the physician for administering multiple medications. The package contains a first medication, a second different medication, a third medication different from the first and second medications, and a written protocol specifying the dosage of each of the medications and the time schedule for taking each of the three medications.

This application claims priority from provisional application 61/405,290, filed Oct. 21, 2010, the entire contents of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION

1. Technical Field

This application relates to medication packages for patients and more particularly to medication packages containing combinations of select medications to simplify the process of prescribing and administering medications.

2. Background of Related Art

Currently, in many instances, certain combinations of prescription medications are required. In such combinations, the selection of the medications as well as the time periods for taking the medications are essential. Although there are certain established guidelines for such prescriptions, they may still vary among practitioners. Part of this variation is due to differing surgical protocols for which the medications are targeted. Problems may arise as practitioners individually prescribe these medications. Additionally, confusion and mistakes can occur by the pharmacies in creating the combinations as well as by the patients in taking the prescribed dosage at the prescribed times.

The need exists to simplify the prescribing and administering of such combinations of select medications.

SUMMARY

In one aspect, the present invention provides a medication package for premedicating patients with potential allergies to X-ray contrast agents. The package contains therein an H1 blocking agent, an H2 blocking agent, and an immunosuppressant, each contained separately in the package. The package includes a written protocol identifying each medication, a quantity to be taken and a time schedule for taking the medications.

In some embodiments, the H1 blocking agent is the antihistamine diphenhydramine (or an equivalent), the H2 blocking agent is cimetidine (or an equivalent) and/or the immunosuppressant is prednisone (or an equivalent) or methylprednisolone (or an equivalent).

In another aspect, the present invention provides a medication package enabling a single prescription to be written by the physician for administering multiple medications, the package containing a first medication, a second different medication, and a third medication different from the first and second medications. The package includes a written protocol specifying a dosage of each of the medications and a time interval for taking each of the three medications.

In some embodiments, the first, second and third medications are contained within separate compartments in the package. In other embodiments, the package contains a first compartment containing each of the three medications prescribed in a first administering of the medications and a second compartment containing each of the three medications prescribed in a second administering of the medications.

In some embodiments, the first, second and third medications are color coded.

In some embodiments, the package contains medications to pre-medicate a patient with potential allergies to iodine based X-ray contrast agents. In some embodiments, the first medication is an oral steroid, the second medication is an antihistamine and the third medication is a histamine H2 receptor antagonist.

In another aspect, the present invention provides a prepackaged combination of medications enabling a physician to write a single prescription for multiple medications. The package comprises multiple medications grouped in a preselected (predetermined) arrangement and instructions identifying a quantity of each set of medications for the patient to take and a time interval for taking a first set of medications and a subsequent set of medications.

In some embodiments, the first set of medications is contained in a separate package from the subsequent set of medications. In some embodiments, the instructions include a time interval for taking additional subsequent set(s) of the medications.

In some embodiments, each medication is contained in a separate compartment with instructions of the time to take prior to the surgical procedure.

In some embodiments the prepackaged combination is designed to pre-medicate patients with potential allergies to iodine based X-ray contrast agents.

DETAILED DESCRIPTION OF THE DRAWINGS

Preferred embodiments of the present disclosure are described herein with reference to the drawings wherein:

FIG. 1 is a schematic view of a first medication package of the present invention;

FIG. 2 is a schematic view of an alternate medication package of the present invention;

FIG. 3 is a schematic view of another alternate medication package of the present invention;

FIG. 4 is a top view of still another alternate medication package of the present invention; and

FIG. 5 is a top view of another alternate medication package of the present invention.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Various medication packages are disclosed herein which avoid the foregoing disadvantages of individually prescribed medications/agents which must be taken in combination by the patient. In accordance with the present invention, each of the medication packages (patient convenience packs) falls under a single prescription, with the single prescription embodying several different medications with instructions for dosage and time intervals for taking the medications. The convenience pack allows physicians to write one simple prescription without the necessity of remembering the doses/schedule of medications. The packages can have numerous applications as they can be applicable to a variety of medication combinations. Several examples of such combinations of different medications are described herein, it being understood that other medication combinations are also within the scope of the present invention.

In one example, the medication packages are designed for use with iodinated contrast agents used in radiology and cardiology. In this example, the packages are designed to replace individually prescribed medications used to premedicate patients with suspected/documented allergies to X ray contrast agents, e.g. iodine based contrast agents used in radiology and cardiology. Iodine based X ray contrast agents are used for patients undergoing a variety of radiographic procedures including contrast enhanced computed tomography, intravenous urography, angiography, venography and myelography. The medications to premedicate patients include, but are not limited to, a combination of oral steroids, and histamine receptor blockers including both H1 and H2 blocking agents. More specifically, common combinations include for example a histamine H2-receptor antagonist such as cimetidine or the equivalent, an H1 receptor antagonist such as the antihistamine diphenhydramine or the equivalent, and an immunosuppressant drug such as an oral steroid prednisone or the equivalent or methylprednisolone or the equivalent.

The contrast agents can be administered intravenously, intra-arterially, intra-catheterally as well as into abdominal or other visceral cavities. Although, the incidence of reactions to the contrast agents is low, severe reactions can be life threatening. Reactions to contrast media administration can be divided into two basic types; anaphylactoid and non-anaphylactoid. Anaphylactoid reactions tend to mimic an anaphylactic (allergic) reaction, with enzyme induction causing the release of vasoactive substances such as histamine and serotonin and eventual activation of the complement system. These reactions can have serious and potentially fatal complications. These reactions are more frequent in patients with asthma, a history of prior reactions, a history of cardiovascular and renal disease and those on beta blockers. These reactions typically begin within twenty minutes of injection and are dose independent. Symptoms range from mild (e.g. skin rash, itching, nasal discharge), moderate (e.g. preceding and facial/laryngeal edema, bronchospasm, dyspnea, tachycardia, bradycardia) and severe (e.g. life-threatening arrhythmias, hypotension, overt bronchospasm, laryngeal edema, pulmonary edema, seizure, syncope and death). Non-anaphylactoid reactions are believed to be dependent on the physical properties of the contrast medium (tonicity and osmolality, iodine concentration and volume and rout of administration). Symptoms include warmth, metallic taste, nausea, vomiting, bradycardia, hypotension, vasovagal reactions, neuropathy and delayed reactions.

A full history to assess for factors predisposing a patient to contrast reaction is obtained prior to contrast administration. Premedication is considered when a patient requires intravenous contrast but has had a prior reaction to the contrast. Patients with a shell-fish allergy, asthma, and/or a prior history of reactions are more prone to reactions. Several orally administered premedication combinations have been studied and are in current clinical practice. The American College of Radiology and the American College of Cardiology/Society for Cardiac angiography and interventions have also published recommendations for premedications. These include several combinations of steroids (e.g. prednisone and methylprednisoline), H1 blockers (e.g. diphenhydramine) and H2 blockers (e.g. cimetidine). There is data that suggests that premedication with steroids prior to administration of contrast reduces contrast reactions in high risk patients. In addition, H1 and H2 blockers have been studied to further reduce the possibility of an allergic reaction. A comparison of three pretreatment protocols (oral prednisone/intramuscular diphenhydramine, plus oral cimetidine; plus oral ephedrine) favored the use of the added medications (cimetidine and ephedrine) to the pretreatment protocol for the reduction of allergic symptoms. In a review of nine trials using various premedication protocols, it was concluded that with steroid premedication, the incidence of respiratory symptoms reduced from 1.4% to 0.4%, other symptoms reduced from 0.9% to 0.2%. A clemastine-cimetidine combination showed a statistically significant efficacy for prevention of angio-edema. A combination of steroids and H1 blockers reduced the risk of cutaneous symptoms, and a double dose of methylprednisolone reduced the risk of other symptoms like sneezing, emesis and vertigo. Consequently, the advantages of these pretreatment protocols have been well recognized.

Thus, patients with a known history of contrast reactions or of allergies to other medications or food or a history of asthma/atopy are frequently prescribed premedication with a combination of oral steroids and antihistamine agents. Although the American College of Radiology and Society for coronary angiography and intervention has guidelines regarding the choice and duration of these agents, current practice is non-standard with practitioners and institutes oftentimes choosing their own protocol. This leads to confusion regarding the drug(s) and dose prescribed.

The packages (convenient packs) of the present invention advantageously allow dispensers to write a single prescription without the necessity of individually specifying the doses/schedule of medication. These can be based on current standard of care recommendations and modified as new treatment regimes are made practice. The packages also simplify the work of the dispensing pharmacist and make it easier for the patient taking the medication as the package can have color coded tablets and a printed schedule or protocol on the pack for use.

Thus, as can be appreciated, the novel pre-packaging of medicines of the present invention eliminates the necessity of writing separate prescriptions of the individual medications as well as makes it convenient for pharmacists and patients as there will be only a single package with a single set of instructions. Two examples of preselected medication combinations are provided below.

Example 1

Currently, to premedicate a patient undergoing a procedure requiring injection of contrast agent for imaging, the physician would need to write: a) one prescription for prednisone (e.g. 50 mg) with instructions to take 13 hours before the procedure, seven hours before the procedure and one hour before the procedure; b) a second prescription for diphenhydramine HCL (25 mg) with instructions to take one hour before the procedure; and c) a third prescription for Cimetidine (e.g. 300 mg) with instructions to take one hour before the procedure. However, with the pre-med package of the present invention, the physician would need to write only one prescription, e.g. Pre-Med Pack A. Such Pre-Med Pack A would contain these medications with dosage and time instructions.

Example 2

Currently, to premedicate a patient undergoing a procedure requiring injection of contrast agent for imaging, the physician would need to write: a) one prescription for methylprednisone (e.g. 32 mg) with instructions to take 12 hours before the procedure and two hours before the procedure; b) a second prescription for diphenhydramine HCL (e.g. 50 mg) with instructions to take 12 hours before the procedure and two hours before the procedure; and c) a third prescription for Cimetidine (e.g. 300 mg) with instructions to take 12 hours before the procedure and two hours before the procedure. However, with the pre-med package of the present invention, the physician would need to write only one prescription, e.g. Pre-Med Pack B. Such Pre-Med Pack B would contain these medications with dosage and time instructions.

As can be appreciated, the single prescription of the present invention simplifies the prescribing and administering of the medications. FIG. 1 illustrates one example of pre-med convenience package of the present invention containing four types of medication in Pre-Med Pack #1. The medications can be color coded and placed together in the package or provided in a separate sub-package within the package. In the Example of FIG. 3, three prescription medications are provided in Pre-Med Pack #2 shown packaged together but alternately could be packaged separately. Pre-Med Pack #3 of FIG. 2 has multiple medications, also packaged together or alternatively packaged separately within the convenience package. The dosage and time schedule for taking the medications would be included in the package. In this manner, the physician can prescribe for example one of the packages, and the pharmacy would then place the required medications in a select “pre-med package,” thereby simplifying the practice for the physician and pharmacist as well as for the patient.

Other types of pre-med packages are shown in FIGS. 4 and 5. The package of FIG. 4 corresponds to the medications of Example 1 above and the package of FIG. 5 corresponds to the medications of Example 2 above. As shown, each of the medications can be contained in a separate sub-package or compartment of the package, and optionally the package can contain perforations to separate the medications. In FIG. 4, each medicine, e.g. pill, is in a separate sub-package and the subpackages are separated by perforations. In FIG. 5, the medicines, e.g. pills, are in separate sub-packages based on the time schedule and perforations separate the medications by time schedule. Stated another way, in FIG. 5, the medications are in sub-packages based on the time intervals for taking the medications, e.g. the medications taken twelve hours prior to the procedure are separate from the medications taken two hours prior to the procedure. The medications of FIG. 5 can alternatively be packaged separately as in FIG. 4 (and the FIG. 4 medications can be packaged by time interval as in FIG. 5). Other separations and sub-packaging are also contemplated as well as other medications.

While the above description contains many specifics, those specifics should not be construed as limitations on the scope of the disclosure, but merely as exemplifications of preferred embodiments thereof. Those skilled in the art will envision many other possible variations that are within the scope and spirit of the disclosure as defined by the claims appended hereto. 

1. A medication package for premedicating patients with potential allergies to X-ray contrast agents, the package comprising an H1 blocking agent, an H2 blocking agent, and an immunosuppressant medication, each contained separately in the package, and a written protocol identifying each medication, a quantity required and a time schedule for taking the medication.
 2. The package of claim 1, wherein the H1 blocking agent is the antihistamine diphenhydramine.
 3. The package of claim 1, wherein the H2 blocking agent is cimetidine.
 4. The package of claim 2, wherein the H2 blocking agent is cimetidine.
 5. The package of claim 1, wherein the immunosuppressant is one of prednisone and methylprednisolone.
 6. The package of claim 2, wherein the immunosuppressant is one of prednisone and methylprednisolone.
 7. The package of claim 3, wherein the immunosuppressant is one of prednisone and methylprednisolone.
 8. The package of claim 4, wherein the immunosuppressant is one of prednisone and methylprednisolone.
 9. A medication package enabling a single prescription to be written by the physician for administering multiple medications, the package containing a first medication, a second different medication, a third medication different from the first and second medications, and a written protocol specifying the dosage of each of the three medications and the time schedule for taking each of the three medications.
 10. The medication package of claim 9, wherein the first, second and third medications are contained within separate compartments in the package.
 11. The medication package of claim 9, wherein the package contains a first compartment containing each of the three medications prescribed in a first administering of the medications and a second compartment containing each of the three medications prescribed in a second administering of the medications.
 12. The medication package of claim 9, wherein the first, second and third medications are color coded.
 13. The medication package of claim 9, wherein the package contains medications to pre-medicate a patient with potential allergies to iodine based X-ray contrast agents.
 14. The medication package of claim 13, wherein the first medication is a steroid, the second medication is an antihistamine and the third medication is a histamine H2 receptor antagonist.
 15. A prepackaged combination of medications enabling a physician to write a single prescription for multiple medications, the package comprising multiple medications grouped in a predetermined arrangement and instructions identifying a quantity of a first set of medications for the patient to take, a quantity of a second set of medications for the patient to subsequently take, and the time interval between taking the first set of medications and the second set of medications.
 16. The prepackaged combination of medications of claim 15, wherein the first set of medications is contained in a separate package from the second subsequent set of medications.
 17. The prepackaged combination of claim 15, wherein each medication is contained in a separate compartment with instructions of the time to take the medications prior to a surgical procedure.
 18. The prepackaged combination of claim 15, wherein the prepackage combination is designed to premedicate patients with potential allergies to an iodine based X-ray contrast agent. 